Enhancing TMS outcome prediction: the added value of clinical complexity to functional connectivity

Brisbane Convention & Exhibition Centre 

Growing knowledge of the mechanism mediating transcranial magnetic stimulation (TMS) treatment success has driven substantial advances in target refinement for treatment-resistant depression (TRD). However, outcome variability remains, and clinical factors known to be robust prognostic markers of TMS outcomes are often overlooked in past studies aimed at identifying connectivity predictors of treatment response.

Here, we developed a clinical complexity weight index reflecting the accumulative influence of psychiatric comorbidity, concurrent antidepressant status, and treatment resistance. Leveraging two independent TMS cohorts (Brisbane and Melbourne cohorts; n = 96), we sought to investigate the way in which connectivity predictors may be modulated by these clinical factors and identify generalizable connectivity features central to depressive symptom improvement as a function of clinical complexity across the whole brain.